• Utilization Management Clinical…

    CVS Health (Phoenix, AZ)
    …meaningful difference in the lives of children and adolescents? Join Mercy Care as a Behavioral Health Utilization Management Clinician and become part ... of Child Safety (DCS). + Knowledge of Behavioral Health Outpatient Services. + Utilization Management (UM) Experience. **Education** + Master's degree… more
    CVS Health (07/13/25)
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  • Manager Behavioral Health Services

    Elevance Health (Louisville, KY)
    management The **Manager Behavioral Health Services** is responsible for Behavioral Health Utilization Management (BH UM). **How you will ... UM:** MS in social work, counseling, psychology or related behavioral health field or a degree in...and/or outpatient psychiatric and chemical dependency treatment and prior utilization management experience; or any combination of… more
    Elevance Health (07/29/25)
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  • Utilization Review Clinician - ABA

    Centene Corporation (Tallahassee, FL)
    …as experience in applied behavioral analytics (ABA). Additional Details: * Department: Behavioral Health Utilization Management * Business Unit: ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...of care and services are medically appropriate related to behavioral health (BH) and/or autism spectrum disorder… more
    Centene Corporation (08/02/25)
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  • Utilization Review Clinician…

    Centene Corporation (San Antonio, TX)
    …and substance abuse is preferred. + Utilization Review/ Utilization management with behavioral health cases + Precertification, Concurrent Review, ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall… more
    Centene Corporation (07/31/25)
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  • Manager, UM Behavioral Health

    Humana (Oklahoma City, OK)
    …a part of our caring community and help us put health first** The Manager, Utilization Management Behavioral Health utilizes behavioral health ... and communication of medical services and/or benefit administration determinations. The Manager, Utilization Management Behavioral Health works within… more
    Humana (06/26/25)
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  • Utilization Management Clinical…

    CVS Health (Frankfort, KY)
    …FOR LICENSING DETAILS_** This is a fulltime remote Utilization Management Clinical Consultant opportunity with Aetna Better Health of Kentucky. ... management function. **Required Qualifications** + **_Kentucky Licensed Independent Behavioral Health Clinician (_** **_LPCC, LCSW, LMFT, LPAT_** **_)… more
    CVS Health (07/25/25)
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  • LTSS Manager- Must be located in PA or Surrounding…

    UPMC (Pittsburgh, PA)
    …functions through the management of staff and activity which may include behavioral health , utilization management and care management ... **UPMC Health Plan is looking for a Statewide LTSS...for improvement. Supports supervisors managing service coordination and care management staff. **Responsibilities:** + Selects, schedules, assigns, and evaluates… more
    UPMC (07/30/25)
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  • Utilization Review Clinician…

    Centene Corporation (Raleigh, NC)
    …in accordance with regulatory guidelines and criteria + Performs concurrent review of behavioral health (BH) inpatient to determine overall health of ... million members as a clinical professional on our Medical Management / Health Services team. Centene is a diversified,...WORK 10 HOURS.** **THIS ROLE WILL MAINLY SUPPORT MEDICARE BEHAVIORAL HEALTH ALL STATES AND DELAWARE MEDICAID… more
    Centene Corporation (07/19/25)
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  • Utilization Review Intake RN…

    AdventHealth (Glendale Heights, IL)
    …AVE, Glendale Heights, IL 60139 **The role you'll contribute:** The role of the Utilization Management (UM) Registered Nurse (RN) is to use clinical expertise by ... including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable for a...+ Associate's of Nursing Required + RN experience in behavioral health preferred + Must be able… more
    AdventHealth (06/13/25)
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  • Manager Case Management Long-term Care…

    Highmark Health (Dover, DE)
    …internal departments including but not limited to Medical Directors, Behavioral Health Teams, Disease Management , and Utilization Review. The incumbent ... including but not limited to Medical Directors, Behavioral Health Teams, Disease Management , and Utilization Review. + Accountable for special projects… more
    Highmark Health (06/27/25)
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